The Pharmaceutical Assemblage: Rethinking Sowa Rigpa and the Herbal Pharmaceutical Industry in Asia

Abstract

Cutting-edge anthropological research on pharmaceuticals aims to trace the connections that link our health and subjectivity, via the drugs we ingest, to contemporary forms of science, governance, and market practice. Yet this research is mostly limited to biomedical pharmaceuticals, ignoring the vast and rapidly growing "traditional" pharmaceutical industry, which connects contemporary forms of culture, capitalism, and politics in arguably even more interesting ways. Addressing this gap, this programmatic essay proposes the concept of the "pharmaceutical assemblage" as a way to assess the traditional pharmaceutical industry as part of Asia's growing knowledge industry sector and the global pharmaceutical nexus. Taking the emerging Sowa Rigpa (also known as Tibetan medicine) industry as a particularly illustrative example, the article outlines an interdisciplinary approach to study this industry as a larger, transnational entity with its own role and dynamics. Identifying and discussing four major domains of the Sowa Rigpa industry-raw materials, drug-manufacturing processes, the market, and intellectual property rights-this article argues that the concept of the pharmaceutical assemblage can generate a much-needed bigger picture of traditional medicine and a fresh perspective on the confluences of culture, health, economy, governance, and the environment in contemporary Asia.

Pathways, intersections, and hotspots

“…Capitalizing on romanticized stereotypes of Tibet on the one side, and the growing market for all things Tibetan among part of the Chinese middle class (Yu 2013) on the other, the Tibetan pharmaceutical industry is a powerful force in shaping the patterns of use of their products. The 'Tibetan pharmaceutical assemblage' (Kloos 2017) is indeed the dominant representation of Tibetan medicine -or Sowa Rigpa -today. What we have aimed to show is that, in Rebgong, resorting to Tibetan medicine is not grounded in this romantic idea of Shangri-la and magic, but is rather a health care choice, one made in a particular context of a public health system with many limitations and challenges, including partial access, low quality of care, and fear of the consequences of prolonged biomedical interventions.…”

“…Tibetan medicine, also called 'Sowa Rigpa', 1 has in the last two decades developed into a flourishing industry not only in China, but also in India, Bhutan, and Mongolia (see Craig 2012;Saxer 2013;Kloos 2017). Supported and encouraged by these national governments, and in varying ways included in the public health system, Tibetan medicine has become a modern traditional medicine employed alongside biomedicine and other medicines.…”

“…4 Observing such strong physical presence in Rebgong and the ongoing rapid economic development of a transnational Sowa Rigpa industry that Kloos (2017) calls the 'Tibetan pharmaceutical assemblage', raises questions about the users of all these services and medicines. While Tibetan medicine is an integrated part of most Tibetans' therapeutic practices, it seems unlikely that their use of such services alone could account for the renewed growth.…”

“…At the same time, traditional medicines are contested in global health policy and development circles, often due to the difficulties of testing efficacy within the dominant randomized clinical trial methodology (see for instance Adams 2016b). Yet, in 2005 WHO estimated that '60-80% of the people in the Global South rely primarily or exclusively on traditional medicines' (Kloos 2017). These numbers indicate that we need to take seriously how people engage with nonbiomedical medicines, not only as traditions that need cultural protection and preservation, or as potential burgeoning industries (Adams 2016a;Kloos 2017), but also as available pathways to better health, experienced as safe and efficacious in an increasingly commodified and instrumentalized health care system.…”

“…At the same time, Tibetan pharmaceuticals and practices in the PRC today are commercialized and commodified (Janes 1995;Adams, Schrempf, and Craig 2010;Saxer 2013;Kloos 2017). 13 Not only a defined minority medicine and thus part of the government's development plan, Tibetan medicine has become a lucrative business.…”